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Pires H, Cardoso L, Lopes AP, Fontes MDC, Santos-Silva S, Matos M, Pintado C, Figueira L, Matos AC, Mesquita JR, Coelho AC. Prevalence and Risk Factors for Hepatitis E Virus in Wild Boar and Red Deer in Portugal. Microorganisms 2023; 11:2576. [PMID: 37894234 PMCID: PMC10609178 DOI: 10.3390/microorganisms11102576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Hepatitis E virus (HEV) is a zoonotic foodborne virus with an annual infection prevalence of 20 million human cases, which seriously affects public health and economic development in both developed and developing countries. To better understand the epidemiology of HEV in Central Portugal, a cross-sectional study was conducted from 2016 to 2023 with sera samples from wild ungulates. The seroprevalence and risk factors for HEV seropositivity were evaluated in the present study. Specifically, antibodies against HEV were determined by a commercial enzyme-linked immune-sorbent assay (ELISA). Our results show that in the 650 sera samples collected from 298 wild red deer and 352 wild boars in Portugal, 9.1% red deer and 1.7% wild boar were positive for antibodies to HEV. Regarding age, the seropositivity in juvenile wild ungulates was 1.3%, whereas it was 7.2% in adults. Logistic regression models investigated risk factors for seropositivity. The odds of being seropositive was 3.6 times higher in adults than in juveniles, and the risk was 4.2 times higher in red deer than in wild boar. Both wild ungulate species were exposed to HEV. The higher seroprevalence in red deer suggests that this species may make a major contribution to the ecology of HEV in Central Portugal. Further research is needed to understand how wildlife affects the epidemiology of HEV infections in Portugal.
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Affiliation(s)
- Humberto Pires
- Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal; (H.P.); (C.P.); (A.C.M.)
| | - Luís Cardoso
- Animal and Veterinary Research Centre (CECAV), Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (L.C.); (A.P.L.); (M.d.C.F.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
| | - Ana Patrícia Lopes
- Animal and Veterinary Research Centre (CECAV), Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (L.C.); (A.P.L.); (M.d.C.F.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
| | - Maria da Conceição Fontes
- Animal and Veterinary Research Centre (CECAV), Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (L.C.); (A.P.L.); (M.d.C.F.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
| | - Sérgio Santos-Silva
- School of Medicine and Biomedical Sciences (ICBAS), Porto University, 4050-313 Porto, Portugal; (S.S.-S.); (J.R.M.)
| | - Manuela Matos
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal;
| | - Cristina Pintado
- Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal; (H.P.); (C.P.); (A.C.M.)
- Research Center for Natural Resources, Environment and Society, Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal;
- Quality of Life in the Rural World (Q-RURAL), Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal
| | - Luís Figueira
- Research Center for Natural Resources, Environment and Society, Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal;
- Quality of Life in the Rural World (Q-RURAL), Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal
| | - Ana Cristina Matos
- Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal; (H.P.); (C.P.); (A.C.M.)
- Research Center for Natural Resources, Environment and Society, Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal;
- Quality of Life in the Rural World (Q-RURAL), Polytechnic Institute of Castelo Branco, 6001-909 Castelo Branco, Portugal
| | - João Rodrigo Mesquita
- School of Medicine and Biomedical Sciences (ICBAS), Porto University, 4050-313 Porto, Portugal; (S.S.-S.); (J.R.M.)
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório Para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
| | - Ana Cláudia Coelho
- Animal and Veterinary Research Centre (CECAV), Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (L.C.); (A.P.L.); (M.d.C.F.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 5000-801 Vila Real, Portugal
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Tolera S, Mengistu DA, Alemu FK, Geremew A, Mulugeta Y, Dirirsa G, Temesgen LM, Diriba W, Mulatu G, Sintie T, Bayu K, Berhanu A. Sero-prevalence of hepatitis viral infections among sanitary workers across worldwide: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:404. [PMID: 37312028 DOI: 10.1186/s12879-023-08354-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 05/27/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Sanitation or sanitary workers are exposed to hepatitis virus infections because of filthy and dangerous working conditions. The current global systematic review and meta-analysis aimed to estimate the pooled sero-prevalence of occupationally associated hepatitis virus infection among them. METHODS Preferred Reporting Items for Systematic Reviews (PRISMA), and Population, Intervention, Comparison, Outcome and study design (PICOS) were used for flow diagram, and review questions, respectively. Four databases other methods were used published articles from 2000 to 2022. Boolean logic (AND, OR), MeSH, and keywords were used: (Occupation *OR Job *OR Work) AND (Hepatitis A *OR Hepatitis B virus *OR Hepatitis C virus *OR Hepatitis E virus) AND (Solid waste collectors [SWCs] *OR Street sweepers [SS] *OR Sewage workers [STWs] *OR health care facilities cleaners [HCFCs)) AND (Countries). Stata MP/17 software was used for pooled prevalence analysis, meta-regression analysis (Hedges) at a 95% confidence interval (CI:95%). RESULTS A total of 182 studies were identified studies, a total of 28 studies were included from twelve countries. Of these, from developed (n = 7) and developing countries (n = 5). From total a of 9049 sanitary workers, 5951(66%), 2280 (25%) and 818 (9%) were STWs, SWCs and SS, respectively. Globally, the pooled sero-prevalence of occupational-related hepatitis viral infections among sanitary workers was 38.06% (95% CI: 30-0.46.12). Of this, it was 42.96% (95% CI: 32.63-53.29) and 29.81% (95% CI: 17.59-42.02) for high-income and low-income countries, respectively. Meanwhile, by sub-analysis, the highest pooled sero-prevalence of hepatitis viral infections by categories, type and year were 47.66% (95%CI: 37.42-57.90), 48.45% (95% CI: 37.95-58.96), and 48.30% (95% CI: 36.13-60.47) for SWTs, HAV, and 2000 to 2010 year, respectively. CONCLUSION The consistency of the evidence suggests that sanitation workers, particularly sewage workers, are susceptible to occupationally acquired hepatitis regardless of their working conditions, necessitating significant changes to occupational health and safety regulations from governmental policies and other initiatives to reduce risks among sanitary workers.
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Affiliation(s)
- Sina Tolera
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia.
| | - Dechasa Adare Mengistu
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Fekade Ketema Alemu
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Abraham Geremew
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Yohannes Mulugeta
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Gebisa Dirirsa
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Liku Muche Temesgen
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Wegene Diriba
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Gutema Mulatu
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Tamagnu Sintie
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Kefelegn Bayu
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
| | - Ashenafi Berhanu
- School of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Ethiopia
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Patrizio L, Elisabetta B, Annamaria P, Giancarlo B, Roberta P, Alessio M, Valentina T. Epidemiological and genetic evaluation of HEV in swine slaughtered in Sicily region (Italy). Int J Food Microbiol 2023; 388:110068. [PMID: 36623337 DOI: 10.1016/j.ijfoodmicro.2022.110068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023]
Abstract
Hepatitis E virus (HEV) is the etiological agent of acute viral hepatitis, a disease transmitted by the oral-faecal route. In Europe, zoonotic transmission of HEV-3 genotype is associated with the consumption of raw or slightly cooked meat of pigs and wild boars that are considered the main reservoirs. This work aims to assess the occurrence of swines' HEV RNA liver samples and rectal swabs slaughtered in Sicily using biomolecular methods. HEV-RNA was detected in 17.5 % (21/120) liver samples analyzed and in 3.7 % (3/81) rectal swabs examined. All positive samples were predicted as genotype 3 and subtype 3c (75 %). These data suggest a potential HEV transmission to humans through close contact with pig breeders, veterinarians, slaughterhouse personnel, and pork meat product consumption. Moreover, there are few scientific data evaluating the HEV spread around pigs and humans in Sicily. Therefore, further studies are necessary to correlate humans with swine serotypes and to assess the HEV presence and persistence in food and the risk during the slaughtering process. These surveys allow to clarify the role of the swine species as a potential source of infection for other domestic or wild animals and humans and to establish possible control measures throughout the food chain.
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Affiliation(s)
- Lorusso Patrizio
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Bonerba Elisabetta
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Pandiscia Annamaria
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy.
| | - Bozzo Giancarlo
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Piredda Roberta
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Manfredi Alessio
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
| | - Terio Valentina
- Department of Veterinary Medicine- University of Bari, Provincial Road to Casamassima Km 3, 70010 Valenzano, Bari, Italy
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Geng Y, Shi T, Wang Y. Epidemiology of Hepatitis E. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1417:33-48. [PMID: 37223857 DOI: 10.1007/978-981-99-1304-6_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Hepatitis E virus (HEV) is globally prevalent with relatively high percentages of anti-HEV immunoglobulin G-positive individuals in the populations of developing and developed countries. There are two distinct epidemiological patterns of hepatitis E. In areas with high disease endemicity, primarily developing countries in Asia and Africa, this disease is caused mainly by genotypes HEV-1 or HEV-2; both genotypes transmit predominantly through contaminated water and occur as either outbreaks or sporadic cases of acute hepatitis. The acute hepatitis has the highest attack rate in young adults and is particularly severe among pregnant women. In developed countries, sporadic cases of locally acquired HEV-3 or HEV-4 infection are observed. The reservoir of HEV-3 and HEV-4 is believed to be animals, such as pigs, with zoonotic transmission to humans. The affected persons are often elderly, and persistent infection has been well documented among immunosuppressed persons. A subunit vaccine has been shown to be effective in preventing clinical disease and has been licensed in China.
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Affiliation(s)
- Yansheng Geng
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Tengfei Shi
- Key Laboratory of Public Health Safety of Hebei Province, School of Public Health, Hebei University, Baoding, China
| | - Youchun Wang
- Institute of Medical Biology, Chinese Academy of Medical Science & Peking Union Medical College, Kunming, China.
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Guo Y, Ryan U, Feng Y, Xiao L. Association of Common Zoonotic Pathogens With Concentrated Animal Feeding Operations. Front Microbiol 2022; 12:810142. [PMID: 35082774 PMCID: PMC8784678 DOI: 10.3389/fmicb.2021.810142] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Animal farming has intensified significantly in recent decades, with the emergence of concentrated animal feeding operations (CAFOs) in industrialized nations. The congregation of susceptible animals in CAFOs can lead to heavy environmental contamination with pathogens, promoting the emergence of hyper-transmissible, and virulent pathogens. As a result, CAFOs have been associated with emergence of highly pathogenic avian influenza viruses, hepatitis E virus, Escherichia coli O157:H7, Streptococcus suis, livestock-associated methicillin-resistant Staphylococcus aureus, and Cryptosporidium parvum in farm animals. This has led to increased transmission of zoonotic pathogens in humans and changes in disease patterns in general communities. They are exemplified by the common occurrence of outbreaks of illnesses through direct and indirect contact with farm animals, and wide occurrence of similar serotypes or subtypes in both humans and farm animals in industrialized nations. Therefore, control measures should be developed to slow down the dispersal of zoonotic pathogens associated with CAFOs and prevent the emergence of new pathogens of epidemic and pandemic potential.
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Affiliation(s)
- Yaqiong Guo
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Una Ryan
- Vector- and Water-Borne Pathogen Research Group, Harry Butler Institute, Murdoch University, Murdoch, WA, Australia
| | - Yaoyu Feng
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China.,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, China
| | - Lihua Xiao
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China.,Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, China
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Moro O, Suffredini E, Isopi M, Tosti ME, Schembri P, Scavia G. Quantitative Methods for the Prioritization of Foods Implicated in the Transmission of Hepatititis E to Humans in Italy. Foods 2021; 11:foods11010087. [PMID: 35010213 PMCID: PMC8750432 DOI: 10.3390/foods11010087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 01/02/2023] Open
Abstract
Hepatitis E is considered an emerging foodborne disease in Europe. Several types of foods are implicated in the transmission of the hepatitis E virus (HEV) to humans, in particular, pork and wild boar products. We developed a parametric stochastic model to estimate the risk of foodborne exposure to HEV in the Italian population and to rank the relevance of pork products with and without liver (PL and PNL, respectively), leafy vegetables, shellfish and raw milk in HEV transmission. Original data on HEV prevalence in different foods were obtained from a recent sampling study conducted in Italy at the retail level. Other data were obtained by publicly available sources and published literature. The model output indicated that the consumption of PNL was associated with the highest number of HEV infections in the population. However, the sensitivity analysis showed that slight variations in the consumption of PL led to an increase in the number of HEV infections much higher than PNL, suggesting that PL at an individual level are the top risky food. Uncertainty analysis underlined that further characterization of the pork products preparation and better assessment of consumption data at a regional level is critical information for fine-tuning the most risky implicated food items in Italy.
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Affiliation(s)
- Ornella Moro
- Department of Food Safety, Nutrition and Veterinary Public Health, National Institute of Health, 00161 Rome, Italy; (E.S.); (G.S.)
- Department of Mathematics, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
- Correspondence:
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, National Institute of Health, 00161 Rome, Italy; (E.S.); (G.S.)
| | - Marco Isopi
- Department of Mathematics, University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Maria Elena Tosti
- National Center for Global Health, National Institute of Health, 00161 Rome, Italy;
| | - Pietro Schembri
- Regional Department for Health Activities and Epidemiological Observatory of the Sicilian Region, 90145 Palermo, Italy;
| | - Gaia Scavia
- Department of Food Safety, Nutrition and Veterinary Public Health, National Institute of Health, 00161 Rome, Italy; (E.S.); (G.S.)
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Mrzljak A, Balen I, Barbic L, Ilic M, Vilibic-Cavlek T. Hepatitis E virus in professionally exposed: A reason for concern? World J Hepatol 2021; 13:723-730. [PMID: 34367494 PMCID: PMC8326162 DOI: 10.4254/wjh.v13.i7.723] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 03/31/2021] [Accepted: 06/25/2021] [Indexed: 02/06/2023] Open
Abstract
The zoonotic risk of hepatitis E virus (HEV) is well established. The HEV seroprevalence rates vary according to geographical region, assays used, and study cohorts. HEV infection is still underdiagnosed, implying the need to evaluate the disease's burden in the general population and specific risk groups, such as professionally exposed. Close contact with various animal reservoirs such as pigs, rabbits, sheep, dogs, wild boars, and deer has been associated with higher anti-HEV seroprevalence as a part of occupational exposure. While exact transmission routes remain to be determined, some general preventive measures such as proper hand hygiene, the usage of personal protective equipment, and the thermal processing of food before consumption should be followed. A "One-Health" multisectoral approach should be implemented to achieve optimal health and well-being outcomes, recognizing the interconnections between humans, animals, plants, and their shared environment, in which a vaccine against the zoonotic genotypes 3 and 4 and swine vaccination should be considered as a possible public health measure. This opinion review comprehensively addresses the HEV burden of professional exposure for butchers, slaughterhouse workers, veterinarians, farmers, hunters, and forestry workers delineates the current limits of protective work measures, and tackles future directions.
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Affiliation(s)
- Anna Mrzljak
- Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb 10000, Croatia
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia.
| | - Ivan Balen
- Department of Gastroenterology and Endocrinology, General Hospital “Dr. Josip Bencevic”, Slavonski Brod 35000, Croatia
| | - Ljubo Barbic
- Faculty of Veterinary Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Maja Ilic
- Department of Epidemiology, Croatian Institute of Public Health, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
| | - Tatjana Vilibic-Cavlek
- School of Medicine, University of Zagreb, Zagreb 10000, Croatia
- Department of Virology, Croatian Institute of Public Health, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
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Pavia G, Gioffrè A, Pirolo M, Visaggio D, Clausi MT, Gherardi M, Samele P, Ciambrone L, Di Natale R, Spatari G, Visca P, Casalinuovo F. Seroprevalence and phylogenetic characterization of hepatitis E virus in pig farms in Southern Italy. Prev Vet Med 2021; 194:105448. [PMID: 34333413 DOI: 10.1016/j.prevetmed.2021.105448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 12/27/2022]
Abstract
Hepatitis E virus (HEV) infection is an emerging public health problem in industrialized countries. The infection is associated with waterborne epidemics and transmitted via faecal-oral route. Zoonotic cases of HEV in humans have increased in Europe, and HEV genotype 3 (HEV-3) is the most frequent among humans and animals. Nevertheless, HEV surveillance in the Italian pig farming industry is patchy. Here, HEV prevalence in pig farms located in the Calabria region in Southern Italy was investigated. A total of 692 serum samples were collected from 26 farms and tested for anti-HEV IgG antibody detection. The percentage of HEV-seropositive pigs was 56.8 %. Small farm size, farrow-to-finishing production, and infrequent cleaning procedures were associated with higher HEV seroprevalence. In 12 of the HEV-seropositive farms, 67 faecal samples were collected and 10 of these (10.6 %) tested positive for HEV RNA. Seven of 10 viral RNA sequences were genotyped for phylogenetic analysis, five of which belonged to subtype HEV-3f and two to subtype HEV-3e. The high HEV seroprevalence and the circulation of HEV-3 strains among domestic pigs in the Calabria region pose a risk for the zoonotic transmission of HEV from pigs to occupational exposed workers.
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Affiliation(s)
- Grazia Pavia
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Catanzaro, Italy
| | - Angela Gioffrè
- Department of Medicine, Epidemiology, Workplace and Environmental Hygiene, Lamezia Terme Research Centre, INAIL - National Institute for Insurance against Accidents at Work, Lamezia Terme, Italy
| | - Mattia Pirolo
- Department of Science, Roma Tre University, Viale G. Marconi 446, 00146, Rome, Italy
| | - Daniela Visaggio
- Department of Science, Roma Tre University, Viale G. Marconi 446, 00146, Rome, Italy
| | | | - Monica Gherardi
- Department of Medicine, Epidemiology, Workplace and Environmental Hygiene, Monte Porzio Catone Research Centre, INAIL - National Institute for Insurance against Accidents at Work, Rome, Italy
| | - Pasquale Samele
- Department of Medicine, Epidemiology, Workplace and Environmental Hygiene, Lamezia Terme Research Centre, INAIL - National Institute for Insurance against Accidents at Work, Lamezia Terme, Italy
| | - Lucia Ciambrone
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Catanzaro, Italy
| | - Rossella Di Natale
- Department of Biomedical Sciences, Dental, Morphological and Functional Investigations, University of Messina, Messina, Italy
| | - Giovanna Spatari
- Department of Biomedical Sciences, Dental, Morphological and Functional Investigations, University of Messina, Messina, Italy
| | - Paolo Visca
- Department of Science, Roma Tre University, Viale G. Marconi 446, 00146, Rome, Italy
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Martino C, Rampacci E, Pierini I, Giammarioli M, Stefanetti V, Hyatt DR, Ianni A, Di Paolo G, Coletti M, Passamonti F. Detection of anti-HEV antibodies and RNA of HEV in pigs from a hyperendemic Italian region with high human seroprevalence. Eur J Public Health 2021; 31:68-72. [PMID: 32705126 DOI: 10.1093/eurpub/ckaa112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Pigs are considered the main reservoir of genotypes 3 and 4 of hepatitis E virus (HEV), which is the major cause of acute hepatitis of viral origin in humans worldwide. An increasing number of autochthonous HEV infections have been observed in recent years in industrialized countries, most likely as a result of zoonotic transmission through the consumption of raw or undercooked meat products. METHODS Two hundred and thirty-three blood and liver samples were collected at four different local slaughterhouses from domestic pigs bred in Abruzzo, a region of south-central Italy, where there is the highest human seroprevalence to HEV compared with the rest of Italy. An indirect enzyme-linked immunosorbent assay kit was used for detecting anti-HEV IgG in the sera, while the presence of HEV RNA was investigated by performing a real-time reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS Between 87.3% and 100% of swine serum samples collected in different slaughterhouses of Abruzzo were positive for anti-HEV antibodies. Conversely, none of the liver samples collected from the same animals were positive for HEV by real-time RT-PCR. CONCLUSIONS The hypothesis of foodborne zoonotic transmission from local pigs as responsible for the hyperendemic status of Abruzzo cannot be corroborated. However, the high seroprevalence observed in pigs indicates that HEV is highly circulating in these territories. We propose to further investigate the role of wild fauna and trade in carrier pigs, and the maintenance of HEV virulence in the environment and meat supply chain to shed light on the possible sources of human infection and the degree of occupational risk.
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Affiliation(s)
- Camillo Martino
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Elisa Rampacci
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Ilaria Pierini
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, "Togo Rosati", Perugia, Italy
| | - Monica Giammarioli
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, "Togo Rosati", Perugia, Italy
| | | | - Doreene R Hyatt
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, USA
| | - Andrea Ianni
- Department of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | | | - Mauro Coletti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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Mrzljak A, Jemersic L, Savic V, Balen I, Ilic M, Jurekovic Z, Pavicic-Saric J, Mikulic D, Vilibic-Cavlek T. Hepatitis E Virus in Croatia in the "One-Health" Context. Pathogens 2021; 10:699. [PMID: 34199798 PMCID: PMC8227679 DOI: 10.3390/pathogens10060699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 02/07/2023] Open
Abstract
Hepatitis E virus (HEV) is the most common cause of viral hepatitis globally. The first human case of autochthonous HEV infection in Croatia was reported in 2012, with the undefined zoonotic transmission of HEV genotype 3. This narrative review comprehensively addresses the current knowledge on the HEV epidemiology in humans and animals in Croatia. Published studies showed the presence of HEV antibodies in different population groups, such as chronic patients, healthcare professionals, voluntary blood donors and professionally exposed and pregnant women. The highest seroprevalence in humans was found in patients on hemodialysis in a study conducted in 2018 (27.9%). Apart from humans, different studies have confirmed the infection in pigs, wild boars and a mouse, indicating the interspecies transmission of HEV due to direct or indirect contact or as a foodborne infection. Continued periodical surveys in humans and animals are needed to identify the possible changes in the epidemiology of HEV infections.
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Affiliation(s)
- Anna Mrzljak
- Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Lorena Jemersic
- Department of Virology, Croatian Veterinary Institute, 10000 Zagreb, Croatia;
| | - Vladimir Savic
- Poultry Center, Croatian Veterinary Institute, 10000 Zagreb, Croatia;
| | - Ivan Balen
- Department of Gastroenterology and Endocrinology, General Hospital “Dr. Josip Bencevic”, 35000 Slavonski Brod, Croatia;
| | - Maja Ilic
- Department of Epidemiology, Croatian Institute of Public Health, 10000 Zagreb, Croatia;
| | - Zeljka Jurekovic
- Department of Medicine, Merkur University Hospital, 10000 Zagreb, Croatia;
| | - Jadranka Pavicic-Saric
- Department of Anestesiology, Reanimatology and Intensive Care, Merkur University Hospital, 10000 Zagreb, Croatia;
| | - Danko Mikulic
- Department of Abdominal and Transplant Surgery, Merkur University Hospital, 10000 Zagreb, Croatia;
| | - Tatjana Vilibic-Cavlek
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Department of Virology, Croatian Institute of Public Health, 10000 Zagreb, Croatia
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11
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Alvarado-Esquivel C, Gutierrez-Martinez VD, Ramírez-Valles EG, Sifuentes-Alvarez A. Hepatitis E virus infection and waste pickers: A case-control seroprevalence study. J Med Virol 2021; 93:3779-3785. [PMID: 33230851 DOI: 10.1002/jmv.26688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/21/2020] [Accepted: 11/20/2020] [Indexed: 01/01/2023]
Abstract
Whether waste pickers are a risk group for hepatitis E virus (HEV) infection is largely unknown. This study aimed to determine the association between HEV exposure and the occupation of waste pickers and the work characteristics of waste pickers. An age-and gender-matched case-control seroprevalence study of 86 waste pickers and 86 control subjects of the general population was performed. We determined anti-HEV IgG antibodies in sera of cases and controls using a commercially available enzyme-linked immunoassay. The McNemar's test was used to assess the association between HEV seropositivity and the occupation of waste picker. The association between HEV seropositivity and work characteristics of waste pickers was assessed by bivariate and logistic regression analyses. Anti-HEV IgG antibodies were detected in 14 (16.3%) of the 86 waste pickers and in 8 (9.3%) of the 86 control subjects (McNemar's pair test: odds ratio (OR) = 13.0; 95% confidence interval (CI): 0.73-230.77; p = .02). Bivariate analysis showed that HEV exposure was associated with an ill status (p = .01) and reflexes impairment (p = .009). Logistic regression analysis showed that HEV seropositivity was associated with increasing age (OR = 6.52; 95% CI: 1.95-21.78; p = .002) and raising pigs (OR = 12.01; 95% CI: 1.48-97.26; p = .02). This is the first age- and gender-matched case-control study on the association between HEV infection and the occupation of waste picker. Waste pickers represent a risk group for HEV infection. Factors associated with HEV seropositivity found in this study may help in the design of optimal planning to avoid HEV infection.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | | | | | - Antonio Sifuentes-Alvarez
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
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12
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Abstract
Hepatitis E virus (HEV) is a cosmopolitan foodborne pathogen. The viral agent infects humans through the consumption of contaminated food (uncooked or undercooked). Most cases of infection are asymptomatic and for this reason, this pathology is considered underdiagnosed. Domestic and wild animals are considered natural reservoirs: that is, domestic pig, wild boar, sheep, goat, deer, rabbit, and so on. Therefore, various work categories are at risk: that is, veterinarians, farmers, hunters, slaughterhouse workers, and so on. In these last decades, researchers found a high percentage of positivity to the molecular viral detection in several food matrices included: ready-to-eat products, processed meat products, milk, and shellfish. This review aims to provide an international scenario regarding HEV ribonucleic acid (RNA) detection in several foodstuffs. From this investigative perspective, the study aims to highlight various gaps of the current knowledge about technologies treatments' impact on viral loads. The purpose was also to provide an innovative point of view "One Health"-based, pointing out the strategic role of environmental safety.
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Affiliation(s)
- Gianluigi Ferri
- Faculty of Veterinary Medicine, Department of Food Inspection, University of Teramo, Teramo, Italy
| | - Alberto Vergara
- Post-Graduate Specialization School in Food Inspection "G. Tiecco," Faculty of Veterinary Medicine, Department of Food Inspection, University of Teramo, Teramo, Italy
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13
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Olayinka A, Ifeorah IM, Omotosho O, Faleye TOC, Odukaye O, Bolaji O, Ibitoye I, Ope-Ewe O, Adewumi MO, Adeniji JA. A possible risk of environmental exposure to HEV in Ibadan, Oyo State, Nigeria. J Immunoassay Immunochem 2020; 41:875-884. [PMID: 32787711 DOI: 10.1080/15321819.2020.1804933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hepatitis E virus (HEV) infection is both a major public health concern and emerging global health concern, with a documented incidence of 20 million, 3.4 million clinical cases, 70,000 deaths, and 3,000 stillbirths. The aetiologic agent, HEV is a primarily enterally transmitted hepatotropic virus. Fecal samples were collected from three selected pig farms across Ibadan, South-west Nigeria. Randomly picked samples were pooled per unit pen and fecal suspensions prepared were subjected to HEV Antigen (Ag) enzyme-linked immunosorbent assay. Molecular probing was done by Reverse Transcription and nested polymerase reaction (RT-nPCR) and deep sequencing. Sequencing was done paired-end for 300 cycles using the HiSeq system. Overall farm prevalence of 66.7% (2/3) and prevalence at individual level of 13.2% (9/68) were recorded. All nine samples positive for the ELISA screen were negative when subjected to RT-nPCR assays. Further, on deep sequencing, no HEV genomic fragment was found in the sample using de-novo assembly. Findings suggest possibly inapparent HEV in the pigs studied or a yet to be identified protein with HEV-Ag cross-reactivity ability on ELISA, thus constituting a possible risk of exposure to HEV infection in the population. Consequently, we recommend prompt intervention to unravel the mystery and break the chain of transmission.
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Affiliation(s)
- Adebowale Olayinka
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - I M Ifeorah
- Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology, University of Nigeria, Nsukka, Nigeria
| | - Oladipo Omotosho
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - T O C Faleye
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Centre for Human Virology and Genomics, Department of Microbiology, Nigerian Institute for Medical Research, Lagos, Nigeria
| | - Oladapo Odukaye
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluremi Bolaji
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria 6. Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, NigeriaInfectious Disease Institute, College of Medicine, Unive
| | - Ibipeju Ibitoye
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oludayo Ope-Ewe
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - M O Adewumi
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.,WHO National Polio Laboratory, University of Ibadan, Ibadan, Nigeria
| | - J A Adeniji
- Department of Virology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria.,WHO National Polio Laboratory, University of Ibadan, Ibadan, Nigeria
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14
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Sooryanarain H, Meng XJ. Swine hepatitis E virus: Cross-species infection, pork safety and chronic infection. Virus Res 2020; 284:197985. [PMID: 32333941 DOI: 10.1016/j.virusres.2020.197985] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/11/2020] [Accepted: 04/17/2020] [Indexed: 12/12/2022]
Abstract
Swine hepatitis E virus (swine HEV) belongs to the species Orthohepevirus A within the genus Orthohepevirus in the family Hepeviridae. Four different genotypes of swine HEV within the species Orthohepevirus A have been identified so far from domesticated and wild swine population: genotypes 3 (HEV-3) and 4 (HEV-4) swine HEVs are zoonotic and infect humans, whereas HEV-5 and HEV-6 are only identified from swine. As a zoonotic agent, swine HEV is an emerging public health concern in many industrialized countries. Pigs are natural reservoir for HEV, consumption of raw or undercooked pork is an important route of foodborne HEV transmission. Occupational risks such as direct contact with infected pigs also increase the risk of HEV transmission in humans. Cross-species infection of HEV-3 and HEV-4 have been documented under experimental and natural conditions. Both swine HEV-3 and swine HEV-4 infect non-human primates, the surrogates of man. Swine HEV, predominantly HEV-3, can establish chronic infection in immunocompromised patients especially in solid organ transplant recipients. The zoonotic HEV-3, and to lesser extent HEV-4, have also been shown to cause neurological diseases and kidney injury. In this review, we focus on the epidemiology of swine HEV, host and viral determinants influencing cross-species HEV infection, zoonotic infection and its associated pork safety concern, as well as swine HEV-associated chronic infection and neurological diseases.
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Affiliation(s)
- Harini Sooryanarain
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Xiang-Jin Meng
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
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15
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Mrzljak A, Tabain I, Premac H, Bogdanic M, Barbic L, Savic V, Stevanovic V, Jelic A, Mikulic D, Vilibic-Cavlek T. The Role of Emerging and Neglected Viruses in the Etiology of Hepatitis. Curr Infect Dis Rep 2019; 21:51. [PMID: 31754812 DOI: 10.1007/s11908-019-0709-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW In this review, we present the overview of emerging and neglected viruses associated with liver involvement. RECENT FINDINGS Hepatitis E virus (HEV) emerged in the last two decades, causing hepatitis in many parts of the world. Moreover, liver involvement was also described in some emerging arboviral infections. Many reports showed dengue-associated liver injury; however, chikungunya, West Nile, tick-borne encephalitis, and Zika virus are rarely associated with clinically manifest liver disease. In addition, some neglected highly prevalent viruses such as adenoviruses and parvovirus B19 are capable of causing hepatitis in specific population groups. Anelloviruses (torque teno virus/torque teno mini virus/torque teno midi virus, SEN virus), human bocavirus, pegiviruses, and lymphocytic choriomeningitis virus have shown a little potential for causing hepatitis, but their role in the etiology of liver disease remains to be determined. In addition to the well-known hepatotropic viruses, many emerging and neglected viruses have been associated with liver diseases. The number of emerging zoonotic viruses has been increasingly recognized. While zoonotic potential of HEV is well documented, the recent identification of new hepatitis-related animal viruses such as HEV strains from rabbits and camels, non-primate hepaciviruses in domestic dogs and horses, as well as equine and porcine pegivirus highlights the possible zoonotic transmission in the context of "One Health." However, zoonotic potential and hepatotropism of animal hepatitis viruses remain to be determined.
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Affiliation(s)
- Anna Mrzljak
- Department of Medicine, Merkur University Hospital, Salata 3b, 10000, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Irena Tabain
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Hrvoje Premac
- Department of Medicine, Varazdin General Hospital, Varazdin, Croatia
| | - Maja Bogdanic
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
| | - Ljubo Barbic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Vladimir Savic
- Poultry Center, Laboratory for Virology and Serology, Croatian Veterinary Institute, Zagreb, Croatia
| | - Vladimir Stevanovic
- Department of Microbiology and Infectious Diseases with Clinic, Faculty of Veterinary Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Jelic
- Department of Medicine, Merkur University Hospital, Salata 3b, 10000, Zagreb, Croatia
| | - Danko Mikulic
- Department of Surgery, Merkur University Hospital, Zagreb, Croatia
| | - Tatjana Vilibic-Cavlek
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Virology, Croatian Institute of Public Health, Zagreb, Croatia
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16
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Hoan NX, Huy PX, Sy BT, Meyer CG, Son TV, Binh MT, Giang DP, Tu Anh D, Bock CT, Wang B, Tong HV, Kremsner PG, Song LH, Toan NL, Velavan TP. High Hepatitis E virus (HEV) Positivity Among Domestic Pigs and Risk of HEV Infection of Individuals Occupationally Exposed to Pigs and Pork Meat in Hanoi, Vietnam. Open Forum Infect Dis 2019; 6:ofz306. [PMID: 31660396 PMCID: PMC6735913 DOI: 10.1093/ofid/ofz306] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 06/25/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Hepatitis E virus (HEV) infection can occur through consumption of undercooked pork meat or exposure to animal feces. Because there are scarce data only in developing countries, we assessed whether pigs might be a potential source of human HEV infections in Vietnam. In addition, we determined anti-HEV seroprevalences in the general population and in individuals professionally exposed to pigs and pork meat. METHODS The study took place in Hanoi, Vietnam. Liver tissues from domestic pigs (n = 210) and serum samples obtained from individuals occupationally exposed to pigs and pork meat (n = 283) and from unexposed healthy controls (n = 168) were screened for HEV-ribonucleic acid (RNA) by reverse-transcription polymerase chain reaction. The exposed group was divided into pork meat vendors (n = 81), pig farmers (n = 96), and slaughterers (n = 106). Serum samples were subjected to HEV immunoglobulin (Ig)G and IgM enzyme-linked immunosorbent assays. The HEV genotypes were assessed by direct sequencing, followed by phylogenetic analyses. RESULTS Hepatitis E virus seroprevalence was higher among persons occupationally exposed to pigs/pork meat compared with unexposed individuals (anti-HEV IgM 11% vs 6%, P = .07; anti-HEV IgG 53% vs 31%, P < .0001). Positivity of anti-HEV IgG among slaughterhouse staff was 66%, followed by 51% in pig-farmers and 38% in pork meat vendors (P = .00073). A similar trend was observed for IgM positivity. Of the pig liver tissues, 26 of 210 (12.4%) were positive for HEV-RNA and assessed to be HEV genotype 3. CONCLUSIONS Hepatitis E virus circulates in domestic pigs in Hanoi and constitutes a permanent zoonotic disease risk. The high HEV seroprevalence among occupationally exposed individuals indicates an associated risk of HEV infection.
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Affiliation(s)
- Nghiem Xuan Hoan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Pham Xuan Huy
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Bui Tien Sy
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Christian G Meyer
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
- Duy Tan University, Da Nang, Vietnam
| | - Trinh Van Son
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Mai Thanh Binh
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Dao Phuong Giang
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Dam Tu Anh
- Department of Immunology and Pathophysiology, Hanoi Medical University, Vietnam
| | - C-Thomas Bock
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Bo Wang
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Hoang Van Tong
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Le Huu Song
- Institute of Clinical Infectious Diseases, Hanoi, Vietnam
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
| | - Nguyen Linh Toan
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
- Department of Pathophysiology, Vietnam Military Medical University, Hanoi, Vietnam
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Vietnamese-German Center for Medical Research, Hanoi, Vietnam
- Duy Tan University, Da Nang, Vietnam
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17
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Pathogenic mechanisms and current epidemiological status of HEV infection in asymptomatic blood donors and patients with chronic diseases. Eur J Clin Microbiol Infect Dis 2019; 38:1203-1209. [PMID: 30888550 DOI: 10.1007/s10096-019-03534-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/08/2019] [Indexed: 12/15/2022]
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18
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Huang X, Huang Y, Wagner AL, Chen X, Lu Y. Hepatitis E virus infection in swine workers: A meta-analysis. Zoonoses Public Health 2018; 66:155-163. [PMID: 30548110 DOI: 10.1111/zph.12548] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/29/2018] [Accepted: 11/14/2018] [Indexed: 12/27/2022]
Abstract
Hepatitis E virus (HEV) infects both humans and animals. Swine has been confirmed to be the principal natural reservoir, which raises a concern that HEV infection would be substantially increasing among swine workers. The present study calculated the pooled prevalence of IgG antibodies against HEV among swine workers and the general population in previous cross-sectional studies. We conducted a meta-analysis comparing the prevalence of HEV infection between swine workers and the general population, including local residents, blood donors and non-swine workers. Through searches in three databases (PubMed and OVID in English, and CNKI in Chinese) and after study selection, a total of 32 studies from 16 countries (from 1999 through 2018) were included in the meta-analysis. A random-effect model was employed in the study; an I 2 statistic assessed heterogeneity, and the Egger's test detected publication bias. The comparative prevalence of anti-HEV IgG was pooled from the studies. Compared to the general population, the prevalence ratio (PR) for swine workers was estimated to be 1.52 (95% CI 1.38-1.76) with the I 2 being 71%. No publication bias was detected (p = 0.40). A subgroup analysis further indicated increased prevalence of anti-HEV IgG in the swine workers in Asia (PR = 1.49, 95% CI: 1.35-1.64), in Europe (PR = 1.93, 95% CI: 1.49-2.50) and in all five swine-related occupations, including swine farmers, butchers, meat processors, pork retailers and veterinarians (PR ranged between 1.19 and 1.75). In summary, swine workers have a relatively higher prevalence of past HEV infection, and this finding is true across swine-related occupations, which confirms zoonotic transmission between swine and swine workers.
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Affiliation(s)
- Xiangyuan Huang
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China
| | - Yu Huang
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Xiangxiang Chen
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China
| | - Yihan Lu
- Department of Epidemiology, Fudan University School of Public Health, Key Laboratory of Public Health Safety (Ministry of Education), Shanghai, China.,Fudan University Pudong Institute of Preventive Medicine, Shanghai, China
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19
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Horn J, Hoodgarzadeh M, Klett-Tammen CJ, Mikolajczyk RT, Krause G, Ott JJ. Epidemiologic estimates of hepatitis E virus infection in European countries. J Infect 2018; 77:544-552. [DOI: 10.1016/j.jinf.2018.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/20/2018] [Indexed: 12/16/2022]
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20
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King NJ, Hewitt J, Perchec-Merien AM. Hiding in Plain Sight? It's Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:225-252. [PMID: 29623595 DOI: 10.1007/s12560-018-9342-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 03/29/2018] [Indexed: 06/08/2023]
Abstract
Historically in developed countries, reported hepatitis E cases were typically travellers returning from countries where hepatitis E virus (HEV) is endemic, but now there are increasing numbers of non-travel-related ("autochthonous") cases being reported. Data for HEV in New Zealand remain limited and the transmission routes unproven. We critically reviewed the scientific evidence supporting HEV transmission routes in other developed countries to inform how people in New Zealand may be exposed to this virus. A substantial body of indirect evidence shows domesticated pigs are a source of zoonotic human HEV infection, but there is an information bias towards this established reservoir. The increasing range of animals in which HEV has been detected makes it important to consider other possible animal reservoirs of HEV genotypes that can or could infect humans. Foodborne transmission of HEV from swine and deer products has been proven, and a large body of indirect evidence (e.g. food surveys, epidemiological studies and phylogenetic analyses) support pig products as vehicles of HEV infection. Scarce data from other foods suggest we are neglecting other potential sources of foodborne HEV infection. Moreover, other transmission routes are scarcely investigated in developed countries; the role of infected food handlers, person-to-person transmission via the faecal-oral route, and waterborne transmission from recreational contact or drinking untreated or inadequately treated water. People have become symptomatic after receiving transfusions of HEV-contaminated blood, but it is unclear how important this is in the overall hepatitis E disease burden. There is need for broader research efforts to support establishing risk-based controls.
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Affiliation(s)
- Nicola J King
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand
| | - Joanne Hewitt
- Institute of Environmental Science and Research, 34 Kenepuru Drive, Kenepuru, Porirua, 5022, New Zealand.
| | - Anne-Marie Perchec-Merien
- New Zealand Ministry for Primary Industries, Pastoral House, 25 The Terrace, Wellington, New Zealand
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21
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Strakova P, Kubankova M, Vasickova P, Juricova Z, Rudolf I, Hubalek Z. Hepatitis E virus in archived sera from wild boars (Sus scrofa
), Czech Republic. Transbound Emerg Dis 2018; 65:1770-1774. [DOI: 10.1111/tbed.12950] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/25/2018] [Accepted: 06/08/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Petra Strakova
- Institute of Vertebrate Biology; The Czech Academy of Sciences; Brno Czech Republic
| | | | | | - Zina Juricova
- Institute of Vertebrate Biology; The Czech Academy of Sciences; Brno Czech Republic
| | - Ivo Rudolf
- Institute of Vertebrate Biology; The Czech Academy of Sciences; Brno Czech Republic
| | - Zdenek Hubalek
- Institute of Vertebrate Biology; The Czech Academy of Sciences; Brno Czech Republic
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22
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Hepatitis E virus infection in North Italy: high seroprevalence in swine herds and increased risk for swine workers. Epidemiol Infect 2017; 145:3375-3384. [PMID: 29145911 DOI: 10.1017/s0950268817002485] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We determined the hepatitis E virus (HEV) seroprevalence and detection rate in commercial swine herds in Italy's utmost pig-rich area, and assessed HEV seropositivity risk in humans as a function of occupational exposure to pigs, diet, foreign travel, medical history and hunting activities. During 2011-2014, 2700 sera from 300 swine herds were tested for anti-HEV IgG. HEV RNA was searched in 959 faecal pools from HEV-seropositive herds and in liver/bile/muscle samples from 179 pigs from HEV-positive herds. A cohort study of HEV seropositivity in swine workers (n = 149) was also performed using two comparison groups of people unexposed to swine: omnivores (n = 121) and vegetarians/vegans (n = 115). Herd-level seroprevalence was 75·6% and was highest in farrow-to-feeder herds (81·6%). Twenty-six out of 105 (24·8%) herds had HEV-positive faecal samples (25 HEV-3, one HEV-4). Only one bile sample tested positive. HEV seropositivity was 12·3% in swine workers, 0·9% in omnivores and 3·0% in vegetarians/vegans. Factors significantly associated with HEV seropositivity were occupational exposure to pigs, travel to Africa and increased swine workers' age. We concluded that HEV is widespread in Italian swine herds and HEV-4 circulation is alarming given its pathogenicity, with those occupationally exposed to pigs being at increased risk of HEV seropositivity.
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Baumann-Popczyk A, Popczyk B, Gołąb E, Rożej-Bielicka W, Sadkowska-Todys M. A cross-sectional study among Polish hunters: seroprevalence of hepatitis E and the analysis of factors contributing to HEV infections. Med Microbiol Immunol 2017; 206:367-378. [PMID: 28776194 PMCID: PMC5599476 DOI: 10.1007/s00430-017-0515-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 07/24/2017] [Indexed: 12/15/2022]
Abstract
Hepatitis E virus (HEV) is known as zoonotic agent. The main reservoirs of HEV in Europe are pigs, wild boars, and deer. Hunting activity is considered to be a risk factor for HEV infection. We conducted a cross-sectional study among 1021 Polish hunters. To understand socio-demographic characteristics of this population and to gather information on potential exposures, all participants completed a questionnaire. Commercial immunoassays were employed to estimate seroprevalence anti-HEV. Samples with confirmed positive result of anti-HEV IgM were examined for HEV RNA. Anti-HEV IgG were identified in 227 people, 22.2% of the studied group. Seroprevalence among the studied hunters was associated with age ≥65 [adjusted prevalence ratio (aPR) 1.6, p = 0.037), living in a house (aPR 1.54, p = 0.013), professional contact with farm animals (aPR 1.09, p = 0.01), and consumption of stewed offal (aPR 1.61, p = 0.00). Washing hands after disembowelment was linked to lower seroprevalence (aPR 0.53; p = 0.00). Lower prevalence of anti-HEV IgG among hunters living in cities was associated with age: 35–49 (aPR 0.52, p = 0.011) and 50–64 (aPR 0.93, p = 0.58), living in a house (aPR 1.58, p = 0.002) and owning a cat (aPR 0.58, p = 0.042). Among hunters living in rural areas, seropositivity was associated with contact with farm animals (aPR 1.66, p = 0.013) and consumption of stewed offal (aPR 1.81; p = 0.001). Contrary to initial assumptions, it was concluded that hunting was of significantly lesser importance than other factors. Due to the high level of HEV seroprevalence identified, we recommend conducting a large-scale study in the general population of Poland.
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Affiliation(s)
- Anna Baumann-Popczyk
- Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Chocimska str 24, 00-791, Warsaw, Poland.
| | - Bartłomiej Popczyk
- Department of Genetic and Animal Breeding, Faculty of Animal Science, University of Life Sciences, Warsaw, Poland.,Polish Hunting Association, Warsaw, Poland
| | - Elżbieta Gołąb
- Department of Parasitology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Wioletta Rożej-Bielicka
- Department of Parasitology, National Institute of Public Health-National Institute of Hygiene, Warsaw, Poland
| | - Małgorzata Sadkowska-Todys
- Department of Epidemiology, National Institute of Public Health-National Institute of Hygiene, Chocimska str 24, 00-791, Warsaw, Poland
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Ricci A, Allende A, Bolton D, Chemaly M, Davies R, Fernandez Escamez PS, Herman L, Koutsoumanis K, Lindqvist R, Nørrung B, Robertson L, Ru G, Sanaa M, Simmons M, Skandamis P, Snary E, Speybroeck N, Ter Kuile B, Threlfall J, Wahlström H, Di Bartolo I, Johne R, Pavio N, Rutjes S, van der Poel W, Vasickova P, Hempen M, Messens W, Rizzi V, Latronico F, Girones R. Public health risks associated with hepatitis E virus (HEV) as a food-borne pathogen. EFSA J 2017; 15:e04886. [PMID: 32625551 PMCID: PMC7010180 DOI: 10.2903/j.efsa.2017.4886] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Hepatitis E virus (HEV) is an important infection in humans in EU/EEA countries, and over the last 10 years more than 21,000 acute clinical cases with 28 fatalities have been notified with an overall 10-fold increase in reported HEV cases; the majority (80%) of cases were reported from France, Germany and the UK. However, as infection in humans is not notifiable in all Member States, and surveillance differs between countries, the number of reported cases is not comparable and the true number of cases would probably be higher. Food-borne transmission of HEV appears to be a major route in Europe; pigs and wild boars are the main source of HEV. Outbreaks and sporadic cases have been identified in immune-competent persons as well as in recognised risk groups such as those with pre-existing liver damage, immunosuppressive illness or receiving immunosuppressive treatments. The opinion reviews current methods for the detection, identification, characterisation and tracing of HEV in food-producing animals and foods, reviews literature on HEV reservoirs and food-borne pathways, examines information on the epidemiology of HEV and its occurrence and persistence in foods, and investigates possible control measures along the food chain. Presently, the only efficient control option for HEV infection from consumption of meat, liver and products derived from animal reservoirs is sufficient heat treatment. The development of validated quantitative and qualitative detection methods, including infectivity assays and consensus molecular typing protocols, is required for the development of quantitative microbial risk assessments and efficient control measures. More research on the epidemiology and control of HEV in pig herds is required in order to minimise the proportion of pigs that remain viraemic or carry high levels of virus in intestinal contents at the time of slaughter. Consumption of raw pig, wild boar and deer meat products should be avoided.
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26
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Sommerkorn FM, Schauer B, Schreiner T, Fickenscher H, Krumbholz A. Performance of Hepatitis E Virus (HEV)-antibody tests: a comparative analysis based on samples from individuals with direct contact to domestic pigs or wild boar in Germany. Med Microbiol Immunol 2017; 206:277-286. [DOI: 10.1007/s00430-017-0503-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/16/2017] [Indexed: 12/11/2022]
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Characterization of Viral Exposures in United States Occupational Environments. EXPOSURE TO MICROBIOLOGICAL AGENTS IN INDOOR AND OCCUPATIONAL ENVIRONMENTS 2017. [PMCID: PMC7122517 DOI: 10.1007/978-3-319-61688-9_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Viruses are considered to be the most abundant biological particles and have the capability to infect all forms of life leading to a variety of diseases. American workers in specific occupational environments are threatened by viral exposures, highlighting the importance to recognize the type and risk of exposure, as well as the preventive measures that can be taken to reduce the risk of exposure. For example, healthcare workers can potentially be exposed to air and blood-borne pathogens, such as hepatitis and the human immunodeficiency virus. These types of exposures have led to the development of preventive equipment and regulations intended to reduce viral exposures in occupational settings. This chapter will discuss the characteristics of viruses and the occupationally relevant viruses of which people in varying occupations can potentially encounter. Regulatory guidelines and protective strategies will also be reviewed.
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Colosio C. In this issue of Occupational Medicine. Occup Med (Lond) 2015. [DOI: 10.1093/occmed/kqv174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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